Some environmental consequences of the use of antibiotics: or 'what goes up must come down'

Effects of concentrated poultry operations and cropland manure application on antibiotic resistant Escherichia coli and nutrient pollution in Chesapeake Bay watersheds

Manure from poultry operations is typically applied to nearby cropland and may affect nutrient loading and the spread of antibiotic resistance (ABR). We analyzed the concentrations of nitrogen and phosphorus and the occurrence of ABR in Escherichia coli (E. coli) and extra-intestinal pathogenic E. coli isolates from streams draining 15 small (<19 km²) watersheds of the Chesapeake Bay with contrasting levels of concentrated poultry operations. Total nitrogen and nitrate plus nitrite concentrations increased with poultry barn density with concentrations two and three times higher, respectively, in watersheds with the highest poultry barn densities compared to those without poultry barns. Analysis of N and O isotopes in nitrate by mass spectrometry showed an increase in the proportion of ¹⁵N associated with an increase in barn density, suggesting that the nitrate associated with poultry barns originated from manure. Phosphorus concentrations were not correlated with barn density. Antibiotic susceptibility testing of putative E. coli isolates was conducted using the disk diffusion method for twelve clinically important antibiotics. Of the isolates tested, most were completely susceptible (67%); 33% were resistant to at least one antibiotic, 24% were resistant to ampicillin, 13% were resistant to cefazolin, and 8% were multi-drug resistant. Resistance to three cephalosporin drugs was positively associated with an index of manure exposure estimated from poultry barn density and proportion of cropland in a watershed. The proportion of E. coli isolates resistant to cefoxitin, cefazolin, and ceftriaxone, broad-spectrum antibiotics important in human medicine, increased by 18.9%, 16.9%, and 6.2%, respectively, at the highest estimated level of manure exposure compared to watersheds without manure exposure. Our results suggest that comparisons of small watersheds could be used to identify geographic areas where remedial actions may be needed to reduce nutrient pollution and the public health risks of ABR bacteria.

Patterns of antimicrobial resistance observed in Escherichia coli isolates obtained from domestic- and wild-animal fecal samples, human septage, and surface water

A repeated cross-sectional study was conducted to determine the patterns of antimicrobial resistance in 1,286 Escherichia coli strains isolated from human septage, wildlife, domestic animals, farm environments, and surface water in the Red Cedar watershed in Michigan. Isolation and identification of E. coli were done by using enrichment media, selective media, and biochemical tests. Antimicrobial susceptibility testing by the disk diffusion method was conducted for neomycin, gentamicin, streptomycin, chloramphenicol, ofloxacin, trimethoprim-sulfamethoxazole, tetracycline, ampicillin, nalidixic acid, nitrofurantoin, cephalothin, and sulfisoxazole. Resistance to at least one antimicrobial agent was demonstrated in isolates from livestock, companion animals, human septage, wildlife, and surface water. In general, E. coli isolates from domestic species showed resistance to the largest number of antimicrobial agents compared to isolates from human septage, wildlife, and surface water. The agents to which resistance was demonstrated most frequently were tetracycline, cephalothin, sulfisoxazole, and streptomycin. There were similarities in the patterns of resistance in fecal samples and farm environment samples by animal, and the levels of cephalothin-resistant isolates were higher in farm environment samples than in fecal samples. Multidrug resistance was seen in a variety of sources, and the highest levels of multidrug-resistant E. coli were observed for swine fecal samples. The fact that water sample isolates were resistant only to cephalothin may suggest that the resistance patterns for farm environment samples may be more representative of the risk of contamination of surface waters with antimicrobial agent-resistant bacteria.

Antibiotic resistant bacteria in fish from the Concepción Bay, Chile

Antibiotic resistant bacteria from commercial demersal and pelagic fish captured in the Concepción Bay, Chile were investigated. Viable counts of antibiotic resistant bacteria isolated from gill and intestinal content samples showed high frequencies of resistance to ampicillin, streptomycin and tetracycline, while the proportion of chloramphenicol resistance was rather low. A high incidence of resistance to ampicillin, streptomycin, tetracycline and nitrofurantoin, as well as almost an absence of resistance to gentamicin, amikacin and cotrimoxazole was found among selected isolates which represented the resistant bacterial population. These strains mainly belonged to Vibrionaceae and Enterobacteriaceae and were predominantly resistant to 3 and 4 antibacterials. Isolates from demersal fish exhibited resistance to as many as 8-10 compounds, whereas those from pelagic fish were resistant to seven or fewer antibiotics. These results suggest that Chilean commercial fishes residing in waters near the disposals of urban sewage might play a role as carriers of antibiotic resistant bacteria prompting a health risk to public health for fish consumers.

Handwashing practices and resistance and density of bacterial hand flora on two pediatric units in Lima, Peru

The handwashing practices and bacterial hand flora of 62 pediatric staff members of a teaching hospital in Lima, Peru, were studied. Handwashing followed patient contact 29.3% of the time (204/697 contacts). Mean duration was 14.5 seconds, and significant differences in practices were found by unit (rehydration or neonatal intensive care), type of staff member (nurses or physicians), and type and duration of patient contact. Mean count of colony-forming units was log10 5.87 +/- 0.41, with significant differences in density of flora found between patient care and kitchen staffs. There was no significant effect of handwashing on counts of colony-forming units. Significant differences were also found by unit and by staff position with regard to species isolated and antimicrobial resistance of isolates. A more efficacious and cost-effective form of hand hygiene and a more prudent use of antimicrobial agents are indicated.

Epidemiological study of Staphylococcus aureus resistance to new quinolones in a university hospital

During a 14-month period, from December 1984 to February 1986, 630 Staphylococcus aureus isolates were identified at Broussais Hospital. Thirty-eight isolates (6%), from 35 patients, were found to be pefloxacin-resistant S. aureus (PRSA) with minimal inhibitory concentrations greater than or equal to 8 mg l-1. PRSA isolates were tested for susceptibility to 35 antibiotics, including nine quinolones, and heavy metal ions. Phage-type was determined. Out of the 38 PRSA isolates, 35 (92%) were methicillin- and multiply-resistant; however, all PRSA isolates were sensitive to vancomycin and coumermycin. Fifteen isolates (39%) had similar phage-type and identical antibiotic susceptibility pattern with high level resistance to pefloxacin (MICs equal to 64 mg l-1); they were isolated from the same surgical unit. The 23 remaining PRSA isolates differed by their phage and susceptibility patterns. Pefloxacin MICs ranged from 8 to 512 mg l-1 with a bimodal distribution; cross-resistance was observed with the eight other quinolones tested. Only nine PRSA isolates (24%), including four 'epidemic' isolates, were obtained from patients who had been treated with quinolones. From these data there is apparently no direct relationship between quinolone administration and selection of PRSA in infected patients.

Antimicrobial resistance of Staphylococcus aureus: genetic basis

Images

Association of metal tolerance with multiple antibiotic resistance of bacteria isolated from drinking water

Bacterial isolates from the drinking water system of an Oregon coastal community were examined to assess the association of metal tolerance with multiple antibiotic resistance. Positive correlations between tolerance to high levels of Cu2+, Pb2+, and Zn2+ and multiple antibiotic resistance were noted among bacteria from distribution waters but not among bacteria from raw waters. Tolerances to higher levels of Al3+ and Sn2+ were demonstrated more often by raw water isolates which were not typically multiple antibiotic resistant. A similar incidence of tolerance to Cd2+ was demonstrated by isolates of both water types and was not associated with multiple antibiotic resistance. These results suggest that simultaneous selection phenomena occurred in distribution water for bacteria which exhibited unique patterns of tolerance to Cu2+, Pb2+, and Zn2+ and antibiotic resistance.

The resistance to chemotherapeutic agents of Escherichia coli from domestic dogs and cats

The prevalence of antibiotic resistant Escherichia coli in the rectal flora of 168 healthy dogs and 93 cats in the Brisbane area was investigated. Rectal swabs were plated on MacConkey agar with and without antibiotics, and 690 isolates confirmed as faecal E. coli were tested for resistance to tetracycline, streptomycin, chloramphenicol, ampicillin, neomycin, furazolidone and sulphanilamide. Resistant isolates were obtained from 101 (60%) of the dogs and 24 (26%) of the cats sampled. A high percentage of the isolates was resistant to tetracycline, streptomycin, ampicillin and sulphanilamide. Multiple resistance to 3 or more of the drugs was exhibited by the majority of isolates and a total of 31 different multiple resistance patterns was demonstrated. Of the 50 strains tested for transfer of resistance, 30 (60%) transferred some or all of their resistance determinants to an E. coli K12F - recipient.

In situ studies with membrane diffusion chambers of antibiotic resistance transfer in Escherichia coli

Coliform bacteria were isolated from raw sewage and sewage effluent-receiving waters and tested for their antibiotic susceptibility patterns and their ability to transfer antibiotic resistance to Escherichia coli K-12 C600. An environmental isolate of E. coli (MA527) capable of transferring antibiotic resistance to C600 was mated, both in vitro and in situ, with an antibiotic-sensitive E. coli environmental isolate (MA728). In situ matings were conducted in modified membrane diffusion chambers, in the degritter tank at the Grant Street (Melbourne, Fla.) sewage treatment facility, and in the sewage effluent-receiving waters in Melbourne, Fla. The transfer frequencies in situ were 3.2 x 10(-5) to 1.0 x 10(-6), compared with 1.6 x 10(-4) to 4.4 x 10(-5) observed in vitro. Transfer was shown to occur in raw sewage but was not detected in the effluent-receiving waters. The presence of a 60-megadalton plasmid species in both donor and transconjugants, but not in the recipients, provided physical evidence for the transfer of antibiotic resistance in situ.

The speciation of coliform genera from above and below a sewer outfall and their susceptibilities to antimicrobial agents

The occurrence of coliforms in a small water course was shown to increase by a factor of thirty six below the outfall of a sewage treatment plant. Speciation of the bacteria from above and below the sewer outfall showed that Escherichia coli and Enterobacter species predominated. Drug resistance levels were significant in microorganisms from both sampling sites and the occurrence of a significant number of multiple-resistant microorganisms, particularly E. coli, is reported. Both E. coli and Enterobacter species from below the sewer outfall show a statistically significant increase in resistance to ampicillin and E. coli from below the outfall also shows a statistically significant increase in resistance to sulpha-methoxazole as compared with isolates from above the outfall.

Drug resistance and R plasmids in Escherichia coli strains isolated from imported pet birds

Drug resistance in Escherichia coli strains isolated from pet birds (mynahs, macaws, finches, common bengals, parrots, and flamingos) imported into Japan from 10 foreign countries in 1977 and 1978 was investigated. Of the 309 strains isolated from 127 pet birds in the Animal Quarantine Service, 232 (75.1%) were drug resistant. Furthermore, strains resistant to oxytetracycline hydrochloride, dihydrostreptomycin, and sulfadimethoxine were relatively common. Resistance patterns varied from single to sextuple resistance, and 148 (63.8%) of the resistant strains had conjugative R plasmids. These results suggest that the high incidence of drug resistance and R plasmids in E. coli strains isolated from these pet birds may be a reflection of the prophylactic use of antibiotics for the prevention of diseases which increasingly occur with importation of the birds. Furthermore, the results suggest that the birds may be potential reservoirs of drug-resistant E. coli for families who raise and have intimate contact with such birds.

Antibiotic resistance patterns of gram-negative bacteria isolated from environmental sources

A total of 2,445 gram-negative bacteria belonging to fecal coliform, Pseudomonas, Moraxella, Acinetobacter, and Flavobacterium-Cytophaga groups were isolated from the rivers and bay of Tillamook, Oregon, and their resistances to chloramphenicol (25 microgram/ml), streptomycin (10 microgram/ml), ampicillin (10 microgram/ml), tetracycline (25 microgram/ml), chlortetracycline (25 microgram/ml), oxytetracycline (25 microgram/ml), neomycin (50 microgram/ml), nitrofurazone (12.5 microgram/ml), nalidixic acid (25 microgram/ml), kanamycin (25 microgram/ml), and penicillin G (10 IU/ml) were determined. Among fecal coliforms the bay isolates showed greater resistance to antibiotics than those from tributaries or surface runoff. No such well-defined difference was found among other bacterial groups. The antibiotic resistance patterns of gram-negative bacteria from different sources correlated well, perhaps indicating their common origin. The antibiotic resistance patterns of gram-negative bacteria of different general also correlated well, perhaps indicating that bacteria which share a common environment also share a common mode for developing antibiotic resistance.

Antibiotic resistance of bacteria in water containing ornamental fishes

Water containing ornamental fishes was found to frequently contain countable numbers of bacteria that were resistant to one or more antibiotic or chemotherapeutic agents. The multidrug-resistant strains most commonly isolated were lactose-fermenting Citrobacter freundii. The overall resistance of these aquaria strains was greater than the previously described resistance of clinical isolates of C. freundii. Although the strains examined appeared to lack R-factors, this pool of resistant bacteria may have public health implications.

Antibiotic resistance and survival of E coli in the alimentary tract

Some antibiotics tend to select for R-factor-carrying Escherichia coli in the human gut, with complex long-term consequences. Some resistant strains disappear rapidly when treatment ends, while others persist for months in the absence of obvious antibiotic selection pressure, and the performance of individual resistant strains seems to depend more on the nature of the strain than on the plasmid carried. R plasmids are relatively rare in those E coli that colonize well in the gut and resistant bacteria therefore tend to disappear when treatment ends, but this situation could change dramatically if R plasmids became prevalent among those strains of E coli that colonize effectively.

Distribution of R plasmids among the O-antigen types of Escherichia coli isolated from human and animal sources

The O-antigen types of 600 independently isolated Escherichia coli strains from human feces have been determined, and the types have been related to the antibiotic resistance patterns of the strains. The relative abundance of each O-antigen type differed in the susceptible and resistant series of strains. The majority (86%) of the resistant strains carried R plasmids. Resistant E. coli (20.3%) were found associated with O-antigen types 8, 9 and 101, whereas the susceptible strains covered a wide range of O-antigen types. Examination of 174 resistant strains isolated from calf feces also showed a prevalence of O-antigen types 8, 9, 101 (24.1%), and it seems probable that strains expressing these three O-antigen types commonly carry R plasmids in the alimentary tracts of man and calves. The number of strains not typeable with the O sera available were similar in the human (12.5%) and the calf (11.5%) series. There are no grounds for distinguishing "human" from "calf" E. coli on the basis of their O-antigen reactions.

Evaluation of aquarium antibiotic formulations

The antibacterial activity of eight products marketed for the therapy and prophylaxis of diseases of ornamental fishes was tested. The products contained erythromycin, neomycin, a nitrofuran, penicillin, sulfa compounds, streptomycin, or tetracycline. When used at the concentration recommended by the manufacturer, the products failed to inhibit the growth of bacterial species known to be potential pathogens of ornamental fishes and failed to reduce significantly the bacterial numbers in water containing fish. Concentrations of the products that were bacteriostatic were markedly higher than the in-use concentration recommended by the manufacturer. The danger presented by the unrestricted availability of antibiotic compounds frequently used in the treatment of human and animal disease is discussed.

Survival of R+ Escherichia coli in sea water

The survival of Escherichia coli strains in sea water appears not to be affected by the possession of an R(+) factor. Sea water induces no detectable curing of R(+)E. coli.